Palmetto Health provides tips on managing menopause

Posted on 7/13/2018

OB/GYN Alexander Smyth, M.D., shares his insights on medical and practical approaches
for common symptoms of menopause

Menopause typically occurs between the ages of 46 and 54, and anywhere between 25 to 50 percent of women journey naturally through this change of life without serious complications. For the other half of those experiencing menopause, the resulting hormonal changes can bring on significant side effects ranging from severe hot flashes, night sweats, anxiety, insomnia, vaginal atrophy and even memory lapses.

Alexander Smythe, M.D., a Palmetto Health-USC Medical Group OB/GYN physician at Columbia Women’s Healthcare with nearly 40 years’ experience, said women who experience the more pronounced or abrupt symptoms of menopause are more prone to seek the help of a physician. “They come, basically, running into the office wanting some help,” he said.

Smythe, who is board certified by the American Board of Obstetrics and Gynecology, said many women “suffer in silence” and delay treatment that could bring near immediate relief and prevent future complications. For those and others experiencing symptoms, he notes there are several hormone replacement therapies – including over-the-counter treatments, prescription drugs, patches and creams – that are safe and effective in minimizing or eliminating menopausal side effects.

Smythe points out that some women are not ideal candidates for hormone replacement, including breast cancer patients or those whose mothers, sisters or daughters have had breast cancer. Additionally, anyone who has had a major blood clot typically should avoid such therapies.

When prescribing any medications, Smythe said he and others within Palmetto Health-USC OB/GYN do so conservatively adding that many remedies generally are needed for about five years, after which most women can begin tapering off or discontinuing their use altogether.

“We always try to use the lowest effective dose,” Smythe said, explaining that individual dosages are adjusted based on each patient’s needs.

Only about 2 to 3 percent of women begin menopause earlier than their late 40s, notes Smythe. Many will experience irregular menstrual cycles for a time but are not considered truly menopausal until they have gone a full year without a menstrual cycle.

He goes on to explain that other women with gradual or less severe symptoms – even non-existent in some cases – might postpone seeking help or avoid it completely as their bodies naturally adjust to the changes and their symptoms subside over time.

Some women experience isolated symptoms – even if they have not begun menopause – and there are treatments that can be targeted to each.

Smythe said women approaching menopause, and those who have already started, should stay active and maintain a balanced diet. “All these things make you take a part in your overall health care,” he said.

In some cases, women also might experience depression. An ongoing relationship with a physician is vital so he or she can suggest remedies or refer a patient to another specialist for additional care.

Any younger women who have had their ovaries removed with a hysterectomy for various medical reasons should be treated with hormones before the symptoms of menopause begin.

The important thing, Smythe notes, is that women know relief is within reach. “Most of the time the symptoms will be treatable, and they can be resolved.”

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